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Challenges and Future Trends in Emergency Medicine

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (15 January 2023) | Viewed by 6808

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Special Issue Editors

Prof. Dr. Mariano Scaglione

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Guest Editor

1. Department of Medical Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
2. Department of Radiology, The James Cook University Hospital, Middlesbrough TS4 3BW, UK
3. Department of Radiology, Pineta Grande Hospital, Via Domitiana Km 30, 81030 Castel Volturno, Italy
4. School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
5. Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, Via della Signora 2, 20122 Milan, Italy
Interests: emergency imaging; emergency radiology
Special Issues, Collections and Topics in MDPI journals

Dr. Stefania Tamburrini

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Co-Guest Editor

Department of Radiology, Ospedale del Mare-ASLNa1 Centro, 80147 Napoli, Italy
Interests: ultrasound; computed tomography; emergency radiology; chest imaging; gastrointestinal imaging; urinary imaging; emergency ultrasound; trauma imaging; bowel imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue will focus on the crucial field of emergency imaging, from acute patient scenarios requiring rapid diagnosis to mass-casualty incidents, as well as the organizational and technological advances being made in this area.

Today, the major challenge for emergency radiologists is to match the traditional clinical culture of emergency medicine with the many sophisticated technologies providing a fast and effective contribution in a clinical and therapeutic perspective, in order to have a common language between the emergency physicians and the trauma team, to find human/economical and technical resources for 24/7 coverage and to reduce costs by choosing the appropriate technique for each case.

This is a burgeoning area of clinical interest which has gathered a great deal of attention over the past few years, especially in the wake of several high-profile mass-casualty incidents and the coordinated efforts of the healthcare professionals involved. I think it is very timely to highlight some of the key topics in this field with a series of comprehensive articles from leaders in the field.

It is my hope that this collection of themed articles will provide a comprehensive overview of where emergency radiology stands now, in addition to presenting some stimulating opinions and insights into the future direction of this fascinating field of research and clinical practice.

Prof. Dr. Mariano Scaglione
Dr. Stefania Tamburrini
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (4 papers)

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Research

10 pages, 9473 KiB

Open AccessArticle

Lower Limb Ischemia as Acute Onset of Primary Aortic Occlusion: CTA Imaging and Management

by Giulia Lassandro, Stefania Tamburrini, Carlo Liguori, Stefano Giusto Picchi, Filomena Pezzullo, Giovanni Ferrandino, Fabio Spinetti, Gennaro Vigliotti, Ines Marano and Mariano Scaglione

Int. J. Environ. Res. Public Health 2023, 20(5), 3868; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20053868 - 22 Feb 2023

Viewed by 1504

Abstract

Primary aortic occlusion (PAO) is defined as acute occlusion in the absence of aortic atherosclerosis or aneurysm. PAO is a rare disease with acute onset and can determine massive parenchymal ischemia and distal arterial embolization. The aim of our study was to focus on the assessment of clinical characteristic, CT signs, medical and surgical treatment, complication rates and the overall survival of PAO. Materials and Methods: We retrospectively analyzed the data of all patients with acute lower limb ischemia and a final surgical or discharge diagnosis of PAO who underwent aortic CT angiography in ER settings in our hospital from January 2019 to November 2022. Results: A total of 11 patients (8 males/3 females; male/female ratio, 2.66:1, age range 49 to 79 years-old, mean age 65.27 y/o) with acute onset of lower limb impotence or ischemia were diagnosed with PAO. The etiology was thrombosis in all patients. The aortic occlusion was always located in the abdominal aorta and extended bilaterally through the common iliac arteries. The upper limit of the thrombosis was detected in the aortic subrenal tract in 81.8% of the cases, and in the infrarenal tract in 18.2%. A total of 81.8% of the patients were referred to the ER for symptoms related to lower limb: bilateral acute pain, hypothermia and sudden onset of functional impotence. Two patients (18.2%) died before undergoing surgery for multi-organ failure determined by the severe acute ischemia. The other patients (81.8%) underwent surgical treatment that included aortoiliac embolectomy (54.5%), aortoiliac embolectomy + aorto-femoral bypass (18.2%) and aortoiliac embolectomy and right lower limb amputation (9.1%). The overall mortality was 36.4% while the estimated survival at 1 year was 63.6%. Conclusions: PAO is a rare entity with high morbidity and mortality rates if not recognized and treated promptly. Acute onset of lower limb impotence is the most common clinical presentation of PAO. Aortic CT angiography is the first-choice imaging technique for the early diagnosis of this disease and for the surgical treatment, planning and assessment of any complications. Combined with surgical treatment, anticoagulation is considered the first-line medical therapy at the time of diagnosis, during surgical treatment and after at discharge. Full article

(This article belongs to the Special Issue Challenges and Future Trends in Emergency Medicine)

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15 pages, 1517 KiB

Open AccessArticle

Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign

by Tesfay Mehari Atey, Gregory M. Peterson, Mohammed S. Salahudeen, Luke R. Bereznicki, Tom Simpson, Camille M. Boland, Ed Anderson, John R. Burgess, Emma J. Huckerby, Viet Tran and Barbara C. Wimmer

Int. J. Environ. Res. Public Health 2023, 20(2), 1452; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20021452 - 13 Jan 2023

Cited by 5 | Viewed by 2300

Abstract

Medication errors are more prevalent in settings with acutely ill patients and heavy workloads, such as in an emergency department (ED). A pragmatic, controlled study compared partnered pharmacist medication charting (PPMC) (pharmacist-documented best-possible medication history [BPMH] followed by clinical discussion between a pharmacist and medical officer to co-develop a treatment plan and chart medications) with early BPMH (pharmacist-documented BPMH followed by medical officer-led traditional medication charting) and usual care (traditional medication charting approach without a pharmacist-collected BPMH in ED). Medication discrepancies were undocumented differences between medication charts and medication reconciliation. An expert panel assessed the discrepancies’ clinical significance, with ‘unintentional’ discrepancies deemed ‘errors’. Fewer patients in the PPMC group had at least one error (3.5%; 95% confidence interval [CI]: 1.1% to 5.8%) than in the early BPMH (49.4%; 95% CI: 42.5% to 56.3%) and usual care group (61.4%; 95% CI: 56.3% to 66.7%). The number of patients who need to be treated with PPMC to prevent at least one high/extreme error was 4.6 (95% CI: 3.4 to 6.9) and 4.0 (95% CI: 3.1 to 5.3) compared to the early BPMH and usual care group, respectively. PPMC within ED, incorporating interdisciplinary discussion, reduced clinically significant errors compared to early BPMH or usual care. Full article

(This article belongs to the Special Issue Challenges and Future Trends in Emergency Medicine)

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11 pages, 316 KiB

Open AccessArticle

Willingness and Predictors of Bystander CPR Intervention in the COVID-19 Pandemic: A Survey of Freshmen Enrolled in a Japanese University

by Yukihiro Mori, Yoko Iio, Yuka Aoyama, Hana Kozai, Mamoru Tanaka, Makoto Aoike, Hatsumi Kawamura, Manato Seguchi, Masato Tsurudome and Morihiro Ito

Int. J. Environ. Res. Public Health 2022, 19(23), 15770; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192315770 - 27 Nov 2022

Cited by 1 | Viewed by 1433

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has decreased bystander cardiopulmonary resuscitation (BCPR) intervention rates. The purpose of this study was to elucidate the willingness of university freshmen to provide BCPR during the COVID-19 pandemic and the predictors thereof. A cross-sectional survey of 2789 newly enrolled university students was conducted after the end of the sixth wave of the COVID-19 epidemic in Japan; predictors of willingness to provide BCPR were assessed by regression analysis. Of the 2534 participants 1525 (60.2%) were willing to intervene and provide BCPR during the COVID-19 pandemic. Hesitancy due to the anxiety that CPR intervention might result in poor prognosis was a negative predictor of willingness. In contrast, anxiety about the possibility of infection during CPR intervention did not show a negative impact. On the other hand, interest in CPR and willingness to participate in a course, confidence in CPR skills, awareness of automated external defibrillation, and knowledge of CPR during the COVID-19 pandemic, were also positive predictors. This study suggests that the barrier to willingness to intervene with BCPR during a COVID-19 pandemic is not fear of infection, but rather hesitation due to the possibility of poor prognosis from the intervention. The significance of conducting this study during the COVID-19 epidemic is great, and there is an urgent need for measures to overcome hesitation regarding BCPR. Full article

(This article belongs to the Special Issue Challenges and Future Trends in Emergency Medicine)

7 pages, 888 KiB

Open AccessArticle

Aneurysm Sac Pressure during Branched Endovascular Aneurysm Repair versus Multilayer Flow Modulator Implantation in Patients with Thoracoabdominal Aortic Aneurysm

by Maciej Antkiewicz, Wiktor Kuliczkowski, Marcin Protasiewicz, Tomasz Zubilewicz, Piotr Terlecki, Magdalena Kobielarz and Dariusz Janczak

Int. J. Environ. Res. Public Health 2022, 19(21), 14563; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114563 - 06 Nov 2022

Viewed by 1043

Abstract

Open thoracoabdominal repair is the gold standard in the TAAA treatment. However, there are endovascular techniques, that sometimes may be an alternative, such as branched endovascular aneurysm repair (BEVAR) or implantation of the multilayer flow modulator (MFM). In this study, we aimed to assess differences in the aneurysm sac pressure (ASP) between patients undergoing BEVAR and MFM implantation. The study included 22 patients with TAAA (14 patients underwent BEVAR, while eight MFM implantation). The pressure sensor wire was placed inside the aneurysm. A measurement of ASP and aortic pressure (AP) was performed during the procedure. The systolic pressure index (SPI), diastolic pressure index (DPI), and pulse pressure index (PPI) were calculated as a quotient of the ASP and AP values. After the procedure, SPI and PPI were lower in the BEVAR group than in the MFM group. During a procedure, a drop in SPI and PPI was noted in patients undergoing BEVAR, while no changes were revealed in the MFM group. This indicates that BEVAR, but not MFM, is associated with a reduction in systolic and pulse pressure in the aneurysm sac in patients with TAAA. Full article

(This article belongs to the Special Issue Challenges and Future Trends in Emergency Medicine)

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